The purpose of this paper is to present a hitherto undefined entity which exhibits morphologic features usually associated with mycotic granulomas, North American blastomycosis in particular; the disorder, however, is nothing more than an unusual, and perhaps not so uncommon, tissue reaction to a secondary bacterial infection.

Report of Two Cases

Case 1.—Ten years before his hospital admission, a 61-year-old Negro tailor first noted a circular, crusted lesion about an inch in diameter on the dorsum of the left hand. There was no preceding trauma. The lesion, not studied bacteriologically or mycologically, cleared promptly with intramuscular penicillin therapy. Four years later another similar lesion occurred at a repeatedly traumatized site on the anterior aspect of the left shin. This lesion, still present at the time of admission, had progressed by gradual peripheral extension and central scarring. Two years ago similar new lesions appeared on the